| NPI | 1962713040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: DC MD042990) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT198144) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2015-07-13 |